# DIVINE PEARL HOME HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154996676
- **Authorized official:** MR. ROLANDO DY BUCO (ADMINISTRATOR)
- **Authorized official phone:** (714) 603-7415

## Contact information

- **Practice address:** 121 N STATE COLLEGE BLVD STE 12A, ANAHEIM, CA 92806-2929
- **Practice address phone:** (714) 603-7415
- **Practice address fax:** (714) 603-7439
- **Mailing address:** 121 N STATE COLLEGE BLVD STE 12A, ANAHEIM, CA 92806-2929
- **Mailing address phone:** (714) 603-7415
- **Mailing address fax:** (714) 603-7439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/26/2021
- **Last updated:** 02/06/2024